New Patients

We have two different enrolment forms:

• enrolment package for patients 16 years and older
• enrolment package for patients 15 years and under

Complete these forms and together with a copy of either your birth certificate/passport or proof of residency (work or resident visa) – email to office@titirangimc.co.nz. Alternatively, you can bring these forms along with your birth certificate/passport or proof of residency to the clinic in person.

This enrolment process needs to be completed at least 1 week prior to your first appointment.

Enrolment checklist

Please make sure you have completed and signed:

• ☑ Completed the relevant enrolment forms
• ☑ ProCare enrolment
• ☑ Registration checklist
• ☑ Consent form for request of notes
• ☑ Health365 enrolment (optional)
• ☑ Privacy declaration (optional)
• ☑ Copy of Passport / birth certificate / proof of residency (or bring in person to clinic before first appointment)

Please click here to view the Enrolment Form Guide for Patients (PDF)

Your first appointment with the doctor will need to be a double appointment for the doctor to go through all your medical history. For your initial appointment, we require pre-payment before you see the doctor.